Professional Documents
Culture Documents
Apr 15 Expression of Interest Form Etef Translation and Interpretation
Apr 15 Expression of Interest Form Etef Translation and Interpretation
Expertise France assists the French Development Agency (Agence Française de Développement) by
ensuring the administrative management of the EU-funded project “EVN_Team Europe EVN Energy
Transition Facility” (ETEF) in Vietnam. The beneficiary of this financing is the public operator EVN
Group.
This call for tenders pertains to contract the services of translators (batch 1) and interpreters (batch 2)
to facilitate exchanges between Vietnamese counterparts and technical experts in the framework of
the « EVN – #TEAMEUROPE Energy Transition Facility » project in Vietnam.
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EXPRESSION OF INTEREST FORM
IX – Sworn statement
The tenderer fills in, dates and signs the sworn statement relating to the exclusion criteria and the
absence of conflict of interest provided in the Appendix to this form.
SIGNATURE
Signature of the person authorised to engage and represent the tenderer
I declare that I am applying as part of the call for tenders
Last name: referred to in point II above.
Date:
First name:
Signature:
Role:
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APPENDIX 1
❑ acting in his/her own name (in the case of an application by a physical person with legal
personality):
or
❑ acting as representative of the following legal entity:
1. declares that he/she/it is not in any of the situations referred to in articles L. 2141-1 to L 2141-11
of the French Public procurement code, and in particular those in which he/she/it:
a) has been sentenced by a judgment of a competent authority of a Member State having the
force of res judicata for any offense affecting his/her/its professional integrity;
b) or any member of the management, administrative, executive or supervisory or a physical
person who has powers of representation, of decision or of control over the abovementioned
legal person has not been convicted as referred to in point (a);
c) has not complied with his/her/its obligations relating to the payment of social security
contributions or obligations relating to the payment of taxes in accordance with the legal
provisions of the country where he/she/it is established or those of the contracting authority’s
country or those of the country where the contract is to be executed1;
d) is in a state or is the subject of bankruptcy, liquidation, judicial settlement proceedings or an
arrangement with creditors, cessation of activity, or is in any similar situation resulting from
proceedings of the same kind under the national laws and regulations;
e) has been subject to an administrative penalty issued by a State, by the European Union, by
Expertise France, by any Developing Bank or by any International Organization;
1 Recent certificates or letters issued by the competent authorities of the relevant State are required. These documents
must provide proof of payment of all taxes, duties and social security contributions for which the tenderer is liable,
including VAT, income tax (individuals only), corporation tax (legal entities only) and social security costs.
In the hypothesis of such a decision of exclusion, we can join to the present declaration on honor
the additional information which would allow to consider that this decision of exclusion is not
relevant within the framework of the market.
3. acknowledges that he/she/it may be subject to judicial, administrative and financial penalties if it
is established that misrepresentations have been made or that false information has been
provided.
4. In the event of award of the contract, the following details must be provided upon request and
within the deadline set by the contracting authority:
For the cases mentioned in points (1), a recent extract from the criminal record is required or,
failing that, a recent equivalent document, issued by a judicial or administrative authority of the
country of origin, showing that the requirements concerned are met3.
With regard to the situations described in points (1), when a document referred to in the two
paragraphs above is not issued in the country concerned, it may be replaced by a sworn statement
or, failing that, a solemn declaration, made by the person concerned before a judicial or
administrative authority, a notary or a qualified professional body of the country of origin.
If the tenderer is a legal entity, information concerning individuals having the power of
representation, decision or control over that legal entity must be provided only at the request of
the contracting authority.
2
a conflict of interest may result from economic interests, political or national affinities, family or emotional ties,
or any other type of relationship or common interests;
3
If the tenderer is a legal entity and the national law of the country in which it is established does not provide for the
provision of such proof for legal entities, these documents are required for the relevant individuals, such as company
managers or any person having the power of representation, decision or control of the tenderer.
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SWORN STATEMENT
and against attacks on national peace and security. For information, the lists can be consulted
at the references below:
• for the United Nations, the United Nations Security Council sanctions lists:
https://www.un.org/securitycouncil/content/un-sc-consolidated-list,
• for the European Union, the lists can be consulted at the following address:
https://www.sanctionsmap.eu,
• for France, see: https://gels-avoirs.dgtresor.gouv.fr/List ;
• for the United States, see: https://home.treasury.gov/policy-issues/financial-
sanctions/sanctions-programs-and-country-information,
c) is not subject to a World Bank exclusion order and are not on the list published by the World
Bank. For information, the list can be consulted at the following address:
https://www.worldbank.org/en/projects-operations/procurement/debarred-firms
6. acknowledge and accept that the above-mentioned situations may lead to the automatic
termination of the contract.
7. undertake to inform Expertise France without delay of any change in our situation during the
execution of the Contract with regard to the present declaration.
8. declares that it has read the provisions of this statement and undertakes to comply with them
throughout the procurement procedure.
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APPENDIX 2 DAF_F013ENG_v02
Application date 16/07/2020
Address*
Country*
Branch address *
(a post box number is not enough, enter the full address)
City*
Country*
Account owner
(indicate exactly what is in the bank account details)
Full account number
IBAN/BBAN (*)
(*) If the international bank account number (IBAN) exists in the country where your bank is established
BIC/Swift
Before sending this document, ensure that all information has been provided on this form, otherwise no payments can be made
If you change your account, please fill in this form again with the new information
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